Ledderhose disease (plantar fibromatosis, Morbus Ledderhose)

Ledderhose disease, also called Ledderhose's Disease (LD), plantar fibromas, or Morbus Ledderhose is a fibromatosis, like Dupuytren's contracture. When suffering from Ledderhose disease benign nodules grow at the arch of the foot. Initially these nodules are usually painless but as they grow they can cause considerable pain when walking. The nodules can also inflame causing additional pain.

Occasionally nodules can also start growing in the area of the toes, cords can then develop and toes might contract. Yet this is by far not as frequent as with Dupuytren's contracture.Actually, although fibroma is more commonly found in the arch it can generally be found at any place within the fascia, including the the ball of the foot.

Ledderhose disease is named after the German surgeon Georg Ledderhose who first described it in 1897. For reasons unknown Ledderhose disease (Morbus Ledderhose) is less frequent than Dupuytren's disease but appears often in combination with Dupuytren’s contracture.

Make sure your lumps are diagnosed properly!

Nodules in the foot can have many reasons and Ledderhose disease is only one of them. In a survey of reasons of nodules in the foot DJM Macdonald et al. found "30 different diagnoses ... in 101 patients" "The Differential Diagnosis of Foot Lumps: 101 Cases Treated Surgically in North Glasgow Over 4 Years" Ann R Coll Surg Engl (2007) 89(3): 272–275 full_text. Also see Galois L., Mainard D., and Delagoutte J.P. "Villonodular tumor mimicking a Ledderhose's disease" Foot and Ankle Surgery 9 (2003) p 57 - 59.

Different diseases require different therapies. Therefore prior to any treatment the cause of nodules must first be indentified. Therefore, please do not decide yourself that your nodules in the foot are Ledderhose disease! Make sure you have a professional diagnosis before starting any treatment.

Differences between Ledderhose's and Dupuytren's disease

The first and most important step is the correct diagnosis, which only a medical doctor can provide. Not every nodule in the arch of the foot is Ledderhose's disease therefore see you doctor as soon as possible and stay away from self-diagnosing.

Ledderhose disease (Morbus Ledderhose) probably has the same or similar root cause as Dupuytren’s contracture and in principal the same therapies apply. But feet have to carry a lot of weight and while a patient might be able to avoid the use of an operated hand, this is usually much more inconvenient with an operated foot. Also Ledderhose nodules seem to grow to bigger sizes than Dupuytren nodules. Here is an example:

(Picture provided by David Adams. This picture was actually taken prior to a cryosurgery)

While contraction is usually observed at the hand (Dupuytren's contraction), it is not typical for Ledderhose disease though it might happen. Development of cords seems to be less dominant for Ledderhose. Possibly weight and continuous exercise keep feet and toes straight or the Ledderhose nodules reside in a more static area and are thus subject to less pulling forces than the nodule's in the hand. Thus therapies to straighten toes again are less important for Ledderhose disease, the focus is more on reducing the size of the nodules, reducing pain and inflammation, and maintaining the ability to walk. Therefore therapies for Ledderhose and Dupuytren's are probably as similar as foot and hand: similar, but not the same.